1. Articles from ken-ichi hirata

    1-24 of 39 1 2 »
    1. Favorable early vessel healing after everolimus-eluting stent implantation: 3-, 6-, and 12-month follow-up of optical coherence tomography

      Favorable early vessel healing after everolimus-eluting stent implantation: 3-, 6-, and 12-month follow-up of optical coherence tomography

      Background Although a prospective randomized control study revealed that 3-month dual anti-platelet therapy (DAPT) is safe and does not compromise the efficacy of everolimus-eluting stent (EES) in selected patients, detailed vessel healing at early phase after EES implantation has yet to be investigated in Japanese patients. Methods and results A total of 27 lesions in 19 patients treated with EES were serially evaluated by using optical coherence tomography (OCT) at 3, 6, and 12 months after stent implantation. In addition to standard quantitative OCT parameters, the percentage of stents with peri-strut low-intensity area (PLIA, a region around stent struts homogenously ...

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    2. Lumen Boundaries Extracted from Coronary Computed Tomography Angiography on Computed Fractional Flow Reserve (FFRCT): Validation with Optical Coherence Tomography

      Lumen Boundaries Extracted from Coronary Computed Tomography Angiography on Computed Fractional Flow Reserve (FFRCT): Validation with Optical Coherence Tomography

      Aims: To evaluate the accuracy of minimal lumen area (MLA) by coronary computed tomography angiography (cCTA) and its impact on fractional flow reserve (FFRCT). Methods and results: Fifty-seven patients (118 lesions, 72 vessels) who underwent cCTA and optical coherence tomography (OCT) were enrolled. OCT and cCTA were co-registered and MLAs were measured with both modalities. FFROCT was calculated using OCT-updated models with cCTA-based lumen geometry replaced by OCT-derived geometry. Lesions were grouped by Agatston score (AS) and minimum lumen diameter (MLD) using the OCT catheter and guide wire size (1.0 mm) as a threshold. For all lesions, the average ...

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    3. Impact of CD14++CD16+ monocytes on coronary plaque vulnerability assessed by optical coherence tomography in coronary artery disease patients with well-regulated lipid levels

      Impact of CD14++CD16+ monocytes on coronary plaque vulnerability assessed by optical coherence tomography in coronary artery disease patients with well-regulated lipid levels

      Background and aims This study examined the impact of CD14 ++ CD16 + monocytes on coronary plaque vulnerability, as assessed by optical coherence tomography (OCT), and investigated their association with daily glucose fluctuation. Although increased CD14 ++ CD16 + monocyte levels have been reported to increase cardiovascular events, their impact on coronary plaque vulnerability in coronary artery disease (CAD) patients with or without diabetes mellitus (DM) remains unclear. Methods This prospective observational study included consecutive 50 patients with CAD receiving lipid-lowering therapy and undergoing coronary angiography and OCT. Patients were divided into 3 tertiles according to the CD14 ++ CD16 + monocyte percentages assessed by flow ...

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    4. The impact of serum trans fatty acids concentration on plaque vulnerability in patients with coronary artery disease: Assessment via optical coherence tomography

      The impact of serum trans fatty acids concentration on plaque vulnerability in patients with coronary artery disease: Assessment via optical coherence tomography

      Background and aims Recent epidemiological studies have showed that excessive intake of trans fatty acids (TFA) can be a residual risk for the development of coronary artery disease (CAD) even under medical management, including statins. This study aimed at investigating the association between lipid profile, including serum TFA concentration, and plaque vulnerability using optical coherence tomography (OCT). Methods Level of serum elaidic acid, a major TFA component, was measured using gas chromatography in 161 consecutively enrolled patients with CAD under guideline-directed risk factor management. OCT was performed to evaluate morphological features of angiographic intermediate stenosis (30% < diameter of stenosis <70 ...

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    5. Morphological and pharmacological determinants of peri-procedural myocardial infarction following elective stent implantation: Optical coherence tomography sub-analysis of the PRASFIT-Elective study

      Morphological and pharmacological determinants of peri-procedural myocardial infarction following elective stent implantation: Optical coherence tomography sub-analysis of the PRASFIT-Elective study

      Background Previous studies have suggested that peri-procedural myocardial infarction (PMI) following percutaneous coronary intervention (PCI) is associated with adverse short- and long-term outcomes, and several morphological predictors of PMI have been studied. However, the determinants of PMI under novel anti-platelet therapy are not fully elucidated. Methods and results PRASFIT-Elective is a multicenter, parallel-group study of PCI patients in non-acute settings receiving either prasugrel or clopidogrel in addition to aspirin. Among 742 study patients, 94 (116 lesions) underwent optical coherence tomography (OCT) to evaluate the area of intra-stent tissue (IST, which comprises tissue protrusion and thrombus) after stenting in addition to ...

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    6. Effects of daily glucose fluctuations on the healing response to everolimus-eluting stent implantation as assessed using continuous glucose monitoring and optical coherence tomography

      Effects of daily glucose fluctuations on the healing response to everolimus-eluting stent implantation as assessed using continuous glucose monitoring and optical coherence tomography

      Background Several studies have revealed that glucose fluctuations provoke oxidative stress that leads to endothelial cell dysfunction, progression of coronary atherosclerosis, and plaque vulnerability. However, little is known regarding their effect on neointimal growth after stenting in patients with coronary artery disease (CAD). We aimed to investigate the effects of glucose fluctuations on neointimal growth after everolimus-eluting stent (EES) implantation. Methods This study examined 50 patients who underwent a 9-month follow-up using optical coherence tomography (OCT) after EES implantation. Glucose fluctuation was expressed as the mean amplitude of glycemic excursion (MAGE), and was determined via continuous glucose monitoring before stenting ...

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    7. Impact of final kissing balloon inflation on vessel healing following drug-eluting stent implantation: Insight from the optical coherence tomography sub-study of the J-REVERSE trial

      Impact of final kissing balloon inflation on vessel healing following drug-eluting stent implantation: Insight from the optical coherence tomography sub-study of the J-REVERSE trial

      Background We sought to clarify the impact of final kissing inflation (FKI) after single stenting of bifurcation lesions on vessel healing. Methods From the J-REVERSE registry enrolling 303 bifurcation lesions treated with provisional single stenting using sirolimus- (SES) or everolimus-eluting stent (EES), 65 lesions treated with ( n = 30) and without ( n = 35) FKI underwent 9-month follow-up optical coherence tomography. Average stent eccentricity index (SEI: minimum/maximum stent diameter) and neointimal unevenness score (NUS: maximum/average neointimal thickness of the same cross-section) for the proximal, bifurcation, and distal segments were compared between FKI and non-FKI groups. Results At the proximal segment ...

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    8. The impact of in-stent neoatherosclerosis on long-term clinical outcomes: an observational study from the Kobe University Hospital optical coherence tomography registry

      The impact of in-stent neoatherosclerosis on long-term clinical outcomes: an observational study from the Kobe University Hospital optical coherence tomography registry

      Aims: Although pathological studies have indicated the development of neoatherosclerosis (NA) after stenting, its risk factors and impact on future clinical events remain unclear. We aimed to clarify the possible risk factors for NA development and to evaluate the impact of NA in a large Japanese observational OCT database of patients with coronary heart disease. Methods and results: One hundred and seventy-five consecutive patients (314 lesions) who underwent OCT examination >1 year after bare metal or drug-eluting stent implantation were enrolled. We assessed the presence of NA by follow-up OCT and compared adverse clinical events between NA+ and NA– patients ...

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    9. Differences in Vessel Healing Between Sirolimus- and Everolimus-Eluting Stent Implantation for Bifurcation Lesions: The J-REVERSE Optical Coherence Tomography Substudy

      Differences in Vessel Healing Between Sirolimus- and Everolimus-Eluting Stent Implantation for Bifurcation Lesions: The J-REVERSE Optical Coherence Tomography Substudy

      Background We aimed to clarify the differences in vessel healing after stenting of bifurcation lesions using sirolimus-eluting stents (SESs) or everolimus-eluting stents (EESs). Methods J apanese R egistry Study in Comparison Between Ever olimus-Eluting Stent and S irolimus- E luting Stent for the Bifurcation Lesion (J-REVERSE) is a prospective multicentre registry of 303 bifurcation lesions that were treated with provisional SES or EES with or without final kissing inflation. The first 115 lesions at selected study sites were predefined for inclusion in the optical coherence tomography (OCT) substudy, and 9-month follow-up OCT was conducted in 64 lesions (SES, n = 18 ...

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    10. Optical coherence tomography study of chronic-phase vessel healing after implantation of bare metal and paclitaxel-eluting self-expanding nitinol stents in the superficial femoral artery

      Optical coherence tomography study of chronic-phase vessel healing after implantation of bare metal and paclitaxel-eluting self-expanding nitinol stents in the superficial femoral artery

      Background This study aimed to assess chronic-phase suppression of neointimal proliferation and arterial healing following paclitaxel-coated (PTX) and bare metal stent (BMS) implantation in the superficial femoral artery using optical coherence tomography (OCT). Methods Twenty-five patients with 68 stents underwent an 8-month OCT follow-up. Besides standard OCT variables, neointimal characterization and frequencies of peri-strut low-intensity area (PLIA), macrophage accumulation, and in-stent thrombi were evaluated. Results The mean neointimal thickness was significantly less with PTX stents (544.9 ± 202.2 μm vs. 865.0 ± 230.6 μm, p < 0.0001). The covered and uncovered strut frequencies were significantly smaller and larger ...

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    11. Differences in Vessel Healing between Sirolimus- and Everolimus-eluting Stent Implantation for Bifurcation Lesions: The J-REVERSE OCT Sub-study

      Differences in Vessel Healing between Sirolimus- and Everolimus-eluting Stent Implantation for Bifurcation Lesions: The J-REVERSE OCT Sub-study

      Background We aimed to clarify the differences in vessel healing after stenting for bifurcation lesions using sirolimus-eluting stent (SES) or everolimus-eluting stent (EES). Methods J-REVERSE is a prospective multicenter registry of 303 bifurcation lesions that were treated with provisional SES or EES with or without final kissing inflation. The first 115 lesions at selected study sites were predefined for inclusion in the optical coherence tomography (OCT) sub-study and 9-month follow-up OCT was conducted in 64 lesions (SES: n = 18, EES: n = 46). In addition to standard OCT parameters, stent eccentricity index (SEI; minimum divided by the maximum stent diameter), neointimal ...

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    12. Early Phase Arterial Reaction Following Drug-Eluting and Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction Optical Coherence Tomography Assessment at 2 Weeks

      Early Phase Arterial Reaction Following Drug-Eluting and Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction Optical Coherence Tomography Assessment at 2 Weeks

      The early phase arterial reaction after implantation of second-generation drug-eluting stents (2nd DES) and baremetal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. The MECHANISM pilot study is a multi-center prospective registry that enrolled 24 STEMI patients (from 11 centers) who had undergone implantation of everolimus-eluting ( n = 6), biolimus A9-eluting ( n = 6) or zotarolimus-eluting stents ( n = 6), or BMS ( n = 6). Scheduled optical coherence tomography (OCT) was performed 2 weeks after implantation, and images were independently analyzed at a core laboratory in a blinded fashion. Intra-stent thrombus was quantitatively analyzed in terms of the maximal area ...

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    13. Association between daily glucose fluctuation and coronary plaque properties in patients receiving adequate lipid-lowering therapy assessed by continuous glucose monitoring and optical coherence tomography

      Association between daily glucose fluctuation and coronary plaque properties in patients receiving adequate lipid-lowering therapy assessed by continuous glucose monitoring and optical coherence tomography

      Background Glucose fluctuation has been recognized as a residual risk apart from dyslipidemia for the development of coronary artery disease (CAD). This study aimed to investigate the association between glucose fluctuation and coronary plaque morphology in CAD patients. Methods This prospective study enrolled 72 consecutive CAD patients receiving adequate lipid-lowering therapy. They were divided into 3 tertiles according to the mean amplitude of glycemic excursions (MAGE), which represents glucose fluctuation, measured by continuous glucose monitoring (tertile 1; &lt;49.1, tertile 2; 49.1 ~ 85.3, tertile 3; &gt;85.3). Morphological feature of plaques were evaluated by optical coherence ...

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    14. Serial Optical Coherence Tomography Evaluation at 6, 12, and 24 months Following Biolimus A9-Eluting Biodegradable Polymer Coated Stent Implantation

      Serial Optical Coherence Tomography Evaluation at 6, 12, and 24 months Following Biolimus A9-Eluting Biodegradable Polymer Coated Stent Implantation

      Background Nobori is a biolimus A9-eluting stent (BES) featured with a biodegradable polymer coated on the abluminal side only. We previously reported that favorable vessel healing was achieved at 6-12 months after BES implantation. However, detailed long-term vessel reaction post-BES deployment is unclear. Methods Twenty-two BESs were serially evaluated by optical coherence tomography (OCT) at 6, 12, and 24 months post-stenting. Average neointimal thickness, uncovered struts and neointimal unevenness score (NUS: each cross section as maximum neointimal thickness in one cross section divided by the average neointimal thickness of the same cross-section) were manually measured. In addition, we evaluated the ...

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    15. Optical Coherence Tomography and Histopathology Assessment After Implantation of First- and Second-Generation Drug-Eluting Stents in a Porcine Coronary Model

      Optical Coherence Tomography and Histopathology Assessment After Implantation of First- and Second-Generation Drug-Eluting Stents in a Porcine Coronary Model

      Background: This study directly compared optical coherence tomography (OCT) and histopathology for the assessment of vascular response to first- and second-generation drug-eluting stents. Methods and Results: Sirolimus-, everolimus-, and biolimus-eluting stents (SES, EES, and BES, respectively) were randomly implanted into the coronary arteries of 12 porcine. OCT was conducted after implantation: at 1, 3, and 6 months; histopathology was assessed at 3 and 6 months. At 1-month OCT, EES had the highest neointimal area (NA) and lowest neointimal unevenness score (NUS). At 6 months, NA and NUS were equivalent among the stent types. ∆NA from 1 to 6 months was ...

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    16. Atherosclerotic plaque characterization by CT angiography for identification of high-risk coronary artery lesions: a comparison to optical coherence tomography

      Atherosclerotic plaque characterization by CT angiography for identification of high-risk coronary artery lesions: a comparison to optical coherence tomography

      AIMS: Adverse plaque characteristics (APCs) by coronary computed tomography (CT) angiography (CTA) are associated with myocardial ischaemia and future acute coronary syndromes. The overall objective was to determine whether APCs on non-invasive CTA are associated with vulnerable plaque features by invasive optical coherence tomography (OCT). METHODS AND RESULTS: Sixty-eight coronary plaques in 45 patients were evaluated by CTA and OCT. APCs by CTA were: positive remodelling (PR), remodelling index ≥1.10; low attenuation plaque (LAP), any intraplaque voxel <30 Hounsfield units; spotty calcification (SC), intraplaque calcification ≤3 mm; and 'napkin-ring' sign, low intraplaque attenuation surrounded by a higher attenuation rim ...

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    17. Two-year vessel healing after everolimus-eluting stent implantation: Serial assessment by optical coherence tomography

      Two-year vessel healing after everolimus-eluting stent implantation: Serial assessment by optical coherence tomography

      Background Previous reports have suggested the importance of delayed arterial healing and the development of neoatherosclerosis as major contributors to stent thrombosis and delayed restenosis. The difference of in vivo assessment of long-term vessel healing between first-generation drug-eluting stents and current generation everolimus-eluting stents (EESs) is limited. The aim of this study was to evaluate long-term arterial healing in EES in comparison with the first generation sirolimus-eluting stents (SES). Methods We evaluated 31 EES (23 patients) and 8 SES (7 patients) by serial optical coherence tomography at 12 months (mid-phase) and 24 months (late-phase) after stenting and evaluated the change ...

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    18. Impact of strut-vessel distance and underlying plaque type on the resolution of acute strut malapposition: serial optimal coherence tomography analysis after everolimus-eluting stent implantation

      Impact of strut-vessel distance and underlying plaque type on the resolution of acute strut malapposition: serial optimal coherence tomography analysis after everolimus-eluting stent implantation

      The consequences of acute strut malapposition in everolimus-eluting stents (EES) are unknown. This study investigated the impact of strut–vessel (S–V) distance and plaque type underneath acute strut malapposition on the mid-term vessel response in EES. Twenty-nine patients (35 EES) underwent optical coherence tomography (OCT) immediately after percutaneous coronary intervention and at 8-month follow-up. S–V distance and plaque type (lipid, calcified, or fibrous) underneath acute strut malapposition were evaluated. Follow-up OCT classified acute strut malapposition as persistent or resolved. The S–V cutoff value for predicting resolved strut malapposition and the incidence of intra-stent thrombi were determined. Among ...

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    19. Stabilizing effect of combined eicosapentaenoic acid and statin therapy on coronary thin-cap fibroatheroma

      Stabilizing effect of combined eicosapentaenoic acid and statin therapy on coronary thin-cap fibroatheroma

      Background The addition of highly purified eicosapentaenoic acid (EPA) to statin therapy prevents cardiovascular events. However, the impact of this treatment on vulnerable plaques remains unclear. The aim of this study was to assess the impact of adding EPA to a standard statin therapy on vulnerable plaques by serial optical coherence tomography (OCT). Methods Forty-nine non-culprit thin-cap fibroatheroma (TCFA) lesions in 30 patients with untreated dyslipidemia were included. Patients were randomly assigned to EPA (1800 mg/day) + statin (23 TCFA, 15 patients) or statin only (26 TCFA, 15 patients) treatment. The statin (rosuvastatin) dose was adjusted to achieve a target ...

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    20. Analysis of Long-term Arterial Healing Following Implantation of Different Types of Stents by Optical Coherence Tomography

      Analysis of Long-term Arterial Healing Following Implantation of Different Types of Stents by Optical Coherence Tomography

      Background Although drug-eluting stents have significantly reduced the mid-term incidence of target lesion revascularization, however, in vivo studies on long-term vessel healing of sirolimus-eluting and paclitaxel-eluting stents (SES and PES) are limited. So the aim of this study was to compare long-term arterial healing in SES and PES. Methods We evaluated 27 SES (23 patients) and 21 PES (20 patients) by serial optical coherence tomography (OCT) at 6 months (mid-phase) and ≥3 years (late-phase) after stenting and evaluated the change of neointimal thickness (NIT), the percentages of uncovered and malapposed struts, peri-strut low intensity area (region around stent struts homogenously ...

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    21. Neoatherosclerosis and Mural Thrombus Detection After Sirolimus-Eluting Stent Implantation

      Neoatherosclerosis and Mural Thrombus Detection After Sirolimus-Eluting Stent Implantation

      Background:  Although both optical coherence tomography (OCT) and angioscopy are robust tools for detecting intrastent thrombi and neoatherosclerosis in vivo, whether OCT findings are comparable with angioscopy findings remains unclear. Methods and Results:  22 patients presenting with de novo lesions underwent 26 sirolimus-eluting stent (SES) implantations, with follow-up OCT and angioscopy at 10 months post-implantation for segmental assessment of the proximal, mid-, and distal SES segments (66 segments). The mean signal intensity index (signal intensity of the neointima/signal intensity of fibrous intimal hyperplasia) was quantified for angioscopically detected in-stent yellow and white segments. The detection rate for red thrombi ...

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    22. Potential Benefit of Final Kissing Balloon Inflation After Single Stenting for the Treatment of Bifurcation Lesions – Insights From Optical Coherence Tomography Observation

      Potential Benefit of Final Kissing Balloon Inflation After Single Stenting for the Treatment of Bifurcation Lesions – Insights From Optical Coherence Tomography Observation

      Background:  Treatment of coronary bifurcation lesions using a single stenting strategy is preferable over that using a 2-stent technique. The benefit of final kissing inflation (FKI), however, has not been established. Methods and Results:  Seventy-two patients (76 lesions) with true bifurcation lesions treated with a single drug-eluting stent with FKI (n=33 lesions) or without FKI (non-FKI, n=43 lesions) were enrolled in this study. Optical coherence tomography (OCT) was performed at 6–12 months after implantation. Based on the OCT findings, the percentage of jailing struts (number of jailing struts/total number of struts at the bifurcation lesion) was ...

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    23. Natural consequence of post-intervention stent malapposition, thrombus, tissue prolapse, and dissection assessed by optical coherence tomography at mid-term follow-up

      Natural consequence of post-intervention stent malapposition, thrombus, tissue prolapse, and dissection assessed by optical coherence tomography at mid-term follow-up

      Aims We performed this study to clarify natural consequences of abnormal structures (stent malapposition, thrombus, tissue prolapse, and stent edge dissection) after percutaneous coronary intervention (PCI). Methods and results Thirty-five patients treated with 40 drug-eluting stents underwent serial optical coherence tomography (OCT) imaging immediately after PCI and at the 8-month follow-up. Among a total of 73 929 struts in every frame, 431 struts (26 stents) showed malapposition immediately after PCI. Among these, 49 remained malapposed at the follow-up examination. The mean distance between the strut and vessel wall (S–V distance) of persistent malapposed struts on post-stenting OCT images was ...

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    24. Qualitative and Quantitative Assessment of Stent Restenosis by Optical Coherence Tomography

      Qualitative and Quantitative Assessment of Stent Restenosis by Optical Coherence Tomography

      We hypothesized that the tissue components of in-stent restenosis (ISR) might differ between drug-eluting stents (DES) and bare-metal stents (BMS) and that these differences could be distinguished by qualitative and quantitative optical coherence tomography (OCT) analyses. Methods and Results:  One-hundred and twenty-two initial ISR lesions (sirolimus-eluting stents: n=28; paclitaxel-eluting stents: n=51; BMS: n=43) were evaluated with OCT. Based on their OCT appearance, the lesions were classified as homogeneous, layered or heterogeneous. The optical properties of backscatter, attenuation and signal intensity of the neointimal tissue (NIT) were quantified. To evaluate the vascular response after balloon angioplasty (BA), the ...

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